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Few clinical investigations show that repeated transcranial magnetic stimulation (rTMS) to the brain could produce analgesia. Apart from the relationship between TMS and pain with respect to the clinical observation of rTMS-induced analgesic effects, this article also reviews the effects of pain on motor cortex excitability assessed by single or paired-pulse TMS and the results obtained by applying peripheral magnetic stimulation to treat musculoskeletal pain. This article discusses the effects of acute phasic provoked pain, and prolonged tonic provoked pain on motor cortex excitability. The...

Few clinical investigations show that repeated transcranial magnetic stimulation (rTMS) to the brain could produce analgesia. Apart from the relationship between TMS and pain with respect to the clinical observation of rTMS-induced analgesic effects, this article also reviews the effects of pain on motor cortex excitability assessed by single or paired-pulse TMS and the results obtained by applying peripheral magnetic stimulation to treat musculoskeletal pain. This article discusses the effects of acute phasic provoked pain, and prolonged tonic provoked pain on motor cortex excitability. The analgesic effects resulting from a single session of rTMS are too short-lived and thereby incompatible with a durable control of chronic pain. Repeated sessions of rTMS on consecutive days produce cumulative effects. However, repeated daily rTMS sessions can be applied to control pain syndromes for a limited period. Further work is needed to define the ultimate clinical role of TMS in the management of pain.